李爽, 王欣, 李磊. 地尔硫卓在射血分数保留的心衰患者中临床疗效[J]. 心脏杂志, 2021, 33(3): 261-264. DOI: 10.12125/j.chj.202012085
    引用本文: 李爽, 王欣, 李磊. 地尔硫卓在射血分数保留的心衰患者中临床疗效[J]. 心脏杂志, 2021, 33(3): 261-264. DOI: 10.12125/j.chj.202012085
    shu
    Shuang LI, Xin WANG, Lei LI. Clinical effect of diltiazem in patients with diastolic heart failure[J]. Chinese Heart Journal, 2021, 33(3): 261-264. DOI: 10.12125/j.chj.202012085
    Citation: Shuang LI, Xin WANG, Lei LI. Clinical effect of diltiazem in patients with diastolic heart failure[J]. Chinese Heart Journal, 2021, 33(3): 261-264. DOI: 10.12125/j.chj.202012085
    shu

    地尔硫卓在射血分数保留的心衰患者中临床疗效

    Clinical effect of diltiazem in patients with diastolic heart failure

      摘要
    • 摘要:
        目的   分析地尔硫卓在射血分数保留心衰（HFpEF）患者中的临床疗效。
        方法   入选2016年12月～2018年6月在华中科技大学同济医学院附属武汉市中心医院诊断为HFpEF的患者186例，随机分为对照组（n=93）和地尔硫卓组(n=93)。对照组采用传统药物治疗，治疗组采用传统药物联合盐酸地尔硫卓片治疗，随访12个月。观察两组患者治疗前后6分钟步行试验距离（6 min walking distance，6MWD）、心脏舒张功能改善情况、因急性心力衰竭（AHF）发作再入院率、心源性死亡发生率、全因死亡发生率等指标。
        结果   一般资料方面，两组患者在性别、年龄、高血压性心脏病(HHD)、肥厚型心肌病(HCM)、高脂血症、吸烟史、治疗前6MWD与心脏舒张功能指标差异无统计学意义，地尔硫卓组冠心病（CHD）比例高于对照组（P<0.05）。治疗后与对照组相比，地尔硫卓组6MWD行走的距离明显延长（P<0.01）；心脏舒张功能明显改善，表现在超声心动图（UCG）结果E峰值升高（P<0.01），A峰值与E/A值升高（P<0.05）；氨基末端脑钠肽前体（Nt-pro brain natriuretic peptide，NT-proBNP）下降明显（P<0.01）。随访12个月后，与对照组相比，地尔硫卓组AHF再入院率降低（P<0.05），心源性死亡发生率、全因死亡发生率差异无统计学意义。
        结论   地尔硫卓联合传统药物可提高HFpEF患者运动耐量、改善心脏舒张功能，并可降低患者因急性心衰发作再入院风险。

       

      Abstract:
        AIM   To investigate the clinical effect of diltiazem in heart failure with preserved ejection fraction (HFpEF) patients.
        METHODS   One hundred and eighty-six patients were randomly divided into the diltiazem group and the control group and the basic clinical data of the patients were recorded. The control group was given traditional drug treatment and the treatment group was given traditional Chinese medicine combined with diltiazem hydrochloride. The patients were followed up for 12 months and their 6-minute walk test distance, diastolic functions, readmission rate due to acute-heart-failure (AHF) attack, incidence of cardiac death and the incidence rate for all-cause mortality before and after treatment were compared.
        RESULT   A total of 186 subjects were included, including 93 in the control group and 93 in the diltiazem group. There was no statistical significance in gender, age, hypertensive heart disease, hypertrophic cardiomyopathy, hyperlipidemia or smoking history between the patients of the two groups (P<0.05). The proportion of coronary heart disease in the diltiazem group was higher than that in the control group (P<0.05), which was statistically significant. Before treatment, there was no significant difference in 6 min walking distance between the two groups. After treatment, the 6 min walking distance in the deltiazem group was better than that in the control group (P<0.01). Before treatment, there was no difference in diastolic functions between the two groups. UCG results (E peak, A peak, E/A value) in the diltiazem group were better than those in the control group (P<0.05) and NT-proBNP diltiazem group decreased significantly compared with the control group (P<0.01). The 12-month follow-up found no statistical significance in the incidence of cardiac death or all-cause death between the diltiazem group and the control group, but the rate of readmission due to AHF in the diltiazem group was lower than that in the control group (P<0.05).
        CONCLUSION   Diltiazem combined with basic drugs has remarkable clinical effect in HFpEF patients, which significantly improves the diastolic functions and reduce the readmission due to acute heart failure in HFpEF patients.

       

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